“If I Am HIV-Negative, Then You Must Be Too, Right?”

Falling in love is never easy, but forming a lasting relationship can be even more difficult. For many the early stages of a romance are a combination of excitement, panic and the urge to vomit, a constellation of feelings that Hallmark conveniently labels as “love.” But as relationships develop, a myriad of questions begin to arise: Will his mother like me? Does he always whistle when he pees? Will he judge me for watching Here Comes Honey Boo-Boo? Over 30 years into the HIV epidemic, the relationships formed by gay men and other men who have sex with men (MSM) often face another set of questions: Is he HIV-positive or negative? Is he going to ask if I am positive or negative? True, 30 years of HIV prevention efforts and advocacy have enabled many men living with HIV to be open about their HIV status, and it is certainly true that discussions around HIV are far less stigmatized than they were in the 1980s. But while we have been inundated with messages telling us to “talk about HIV with your sex partners,” for some such discussions are fraught with anxieties over blame, judgment or abandonment.

But for others, the lack of discussion around HIV with their sex partners may arise from a surprising gap in knowledge. Recently published work by Bradley Wagenaar and colleagues from the Rollins School of Public Health in Atlanta shows that among a sample of 426 MSM aged 18 to 29, 21 percent were not definitively aware that sero-discordance (where one member of the couple is HIV-negative and the other is HIV-positive) is possible. That is, 1 in 5 men surveyed thought that if two men were having sex and one was HIV-negative, then the other must also be HIV-negative. This new evidence suggests that gay men may make assumptions about their partner’s sero-status using their own HIV status as a barometer against which to guesstimate their partner’s HIV status. And the logic perhaps makes sense: If I know I am negative, and we have been having a lot of sex together, then he must be negative too, right?